Lower Gastrointestinal Bleeding in Patients with Liver Cirrhosis: Prevalence, Outcomes, and Correlation with MELD Score in an Indian Tertiary Care Facility

Mallipeddi Vivek Vardhan; Aswini Kumar Sahoo; Jimmy Narayan; Samir Sahu; Tapan Kumar Panda; Dattatreya Kar; Lohitha Bhavani Jasthi; Tammineni Roja

doi:10.54133/ajms.v6i1.377

Authors

Mallipeddi Vivek Vardhan Department of General Medicine, IMS and SUM Hospital, Siksha ‘O’ Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India https://orcid.org/0000-0001-6815-3669
Aswini Kumar Sahoo Department of General Medicine, IMS and SUM Hospital, Siksha ‘O’ Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India https://orcid.org/0000-0001-9302-4156
Jimmy Narayan Department of Medical Gastroenterology, IMS and SUM Hospital, Siksha ‘O’ Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India https://orcid.org/0000-0002-8451-1558
Samir Sahu Department of General Medicine, IMS and SUM Hospital, Siksha ‘O’ Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India
Tapan Kumar Panda Department of General Medicine, IMS and SUM Hospital, Siksha 'O' Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India https://orcid.org/0000-0002-0304-8179
Dattatreya Kar Department of Medical Research, IMS and SUM Hospital, Siksha ‘O’ Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India https://orcid.org/0000-0002-8265-6251
Lohitha Bhavani Jasthi Department of General Medicine, IMS and SUM Hospital, Siksha ‘O’ Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India
Tammineni Roja Department of General Medicine, IMS and SUM Hospital, Siksha ‘O’ Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India

DOI:

https://doi.org/10.54133/ajms.v6i1.377

Keywords:

liver cirrhosis, gastrointestinal bleed, MELD score, portal hypertension

Abstract

Background: Lower gastrointestinal bleeding (LGIB) is responsible for 25 percent of overall GI bleeding patients in the general population. In the US, the LGIB incidence is thought to be 21–27/100,000 per year, while the rate of hospitalization is thought to be 20–30/100,000 per year. According to reports, 2–4% of patients hospitalized with LGIB die. Despite the fact that upper GI complications associated with portal hypertension have received a lot of attention, few studies have explored lower GI complications. Objective: To study the prevalence and 28-day outcome of patients hospitalized with lower gastrointestinal bleeding in liver cirrhosis and its correlation with the model for end-stage liver disease (MELD). Method: A single center-based cross-sectional study was conducted for a duration of eighteen months. The main source of data is from patients hospitalized at the Department of General Medicine and Department of Medical Gastroenterology at the Institute of Medical Sciences and SUM hospital, with a minimum of 100 cases. Results: Out of 100 patients, internal hemorrhoids were observed in 50 patients, external hemorrhoids were found only in 1 patient, and rectal varices were present in 17 patients. The MELD score for the 28th day outcome was found to be 21.85 on follow-up. It was 27.0 in discharged patients by the 28th day. Conclusions: An essential element of the condition, portal hypertension, appears to be responsible for the poor prognosis.

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